Guest guest Posted October 20, 2007 Report Share Posted October 20, 2007 This woman did not have enough progesterone to sustain the pregnancy, this is why the 'successful' IVF resulted in a miscarriage. Was she taking supplementary progesterone after the IVF? Her progesterone issue would be the source of my treatment plan from here out. Regarding your question about estrogenic herbs, this is an excellent question and anyone treating fertility should be aware of it. All OB/Gyns will ask this question if they know a pt is taking herbs. I would have to disagree with the post about " have her check with her IVF doctor to see if this may be a common side-effect of the Follicle Stimulating medications or progesterone injections. " As soon as the doc knows the pt is taking herbs, they will 99% surely 'blame' the herbs. This is not a 'common' side effect of hormone stim. I'm not sure why the concern about bleeding. The ART took over her hormones, then she had a miscarriage, now her body is resetting itself to start having menses. It may be a short cycle but that is the consequence of what her body has been through. John Chen did a three part series about estrogenic herbs. I will try to find that for you Sean. In the meantime, I'd recommend getting the Jane Lyttleton book on Treating Infertility with TCM. It's worth it's weight in gold. -p Pamela Zilavy, L.Ac. chexin http://www.change-exchange-interchange.com 415) 279-8376 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 20, 2007 Report Share Posted October 20, 2007 I think Al is right - this is such a common complication / symptom related to / infertility. Some say the Heart controls the opening of the cervix via the bao mai, IIRC. It puts you in a hard position. When people are dropping $15-20k per IVF cycle, they think a $60 acupuncture visit is easy to blame if things go wrong. If you charged $600 a visit, they might think you're great and would not question what you are doing... but since you charge little, they don't think you know what you're doing. Crazy, eh?? Oh, and the herbs, I'm sure you're going to find that they have estrogenic effects, but I would be very surprised if there was any evidence that it had any effect on the IVF... but still, it might just be wise to CYA or just stick with acupuncture pre transfer since most are convinced it can't do anything bad (then it couldn't do anything good either, vis a vis yin / yang, right?). I had a similar situation with a young MD who sought me out when she had a IVF cycle scheduled. She came in and her hair was thin, dry, falling out, and she had 2 days of scanty menses. I suggested she postpone the IVF until things were regulated, but she was anxious, did the IVF, and didn't have good results. It may have not worked even with regular cycles, but from our standpoint, it was not wise to try yet. It's real frustrating when you hear all the stories about the people who try for years and then decide to adopt, and then promptly become pregnant. If any of the more senior practitioners here have any advice, I'd love it if you wouldn't mind sharing! Geoff > You know, the most difficult condition to treat is anxiety. Not because the > problem is symptom is difficult to resolve, but because the patients are > flighty and noncompliant. They're good for about a week, but then they get > (you guessed it) anxious about the formula and stop taking it. So good luck > on this one. > > -- > , DAOM Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 22, 2007 Report Share Posted October 22, 2007 Dear Pamela, You wrote, " I would have to disagree with the post about 'have her check with her IVF doctor to see if this may be a common side-effect of the Follicle Stimulating medications or progesterone injections.' " I think you were referring to my post, so let me clarify. First of all, mid-cycle bleeding and irregular periods are quite common after a post-IVF miscarriage, or even after a failed IVF cycle. For this reason, I thought the patient might take comfort that there was a plausible and clinically sound explanation for her symptoms outside of the Chinese Herbs theory. Also, you said: " This woman did not have enough progesterone to sustain the pregnancy, this is why the 'successful' IVF resulted in a miscarriage. Was she taking supplementary progesterone after the IVF? Her progesterone issue would be the source of my treatment plan from here out. " It is customary for nearly ALL patients to take Progesterone injections following an IVF. This does not necessarily imply a constitutional or functional deficiency of natural progesterone. I may have mis-interpreted your post, but it sounds like you are assuming that her natural progesterone must be low if she was prescribes supplemental progesterone post IVF. If I am reading you correctly, then please be advised that taking progesterone post-IVF is customary, and does not necessarily indicate the need to identify and treat underlying constitutional factors that would lead to low progesterone. David Karchmer The Texas Center for Reproductive Acupuncture www.texasfertilityacupuncture.com , Pamela Zilavy <chexin wrote: > > This woman did not have enough progesterone to sustain the pregnancy, this is why the 'successful' IVF resulted in a miscarriage. Was she taking supplementary progesterone after the IVF? Her progesterone issue would be the source of my treatment plan from here out. Regarding your question about estrogenic herbs, this is an excellent question and anyone treating fertility should be aware of it. All OB/Gyns will ask this question if they know a pt is taking herbs. I would have to disagree with the post about " have her check with her IVF doctor to > see if this may be a common side-effect of the Follicle Stimulating > medications or progesterone injections. " As soon as the doc knows the pt is taking herbs, they will 99% surely 'blame' the herbs. This is not a 'common' side effect of hormone stim. I'm not sure why the concern about bleeding. The ART took over her hormones, then she had a miscarriage, now her body is resetting itself to start having menses. It may be a short cycle but that is the consequence of what her body has been through. > John Chen did a three part series about estrogenic herbs. I will try to find that for you Sean. In the meantime, I'd recommend getting the Jane Lyttleton book on Treating Infertility with TCM. It's worth it's weight in gold. -p > Pamela Zilavy, L.Ac. > chexin > http://www.change-exchange-interchange.com > 415) 279-8376 > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 22, 2007 Report Share Posted October 22, 2007 Dear Geoff, You asked, " If any of the more senior practitioners here have any advice, I'd love it if you wouldn't mind sharing! " I don't know that I would consider myself a 'senior practitioner,' per se. But, I do see dozens and dozens of IVF cases each year. Do you have a more specific question(s)? I don't mind sharing our experiences working with IVF patients, but I'm not too clear about what you are asking. David Karchmer The Texas Center for Reproductive Acupuncture www.texasfertilityacupuncture.com , " G Hudson " <crudo20 wrote: > > I think Al is right - this is such a common complication / symptom > related to / infertility. Some say the Heart controls the opening of > the cervix via the bao mai, IIRC. It puts you in a hard position. > When people are dropping $15-20k per IVF cycle, they think a $60 > acupuncture visit is easy to blame if things go wrong. If you charged > $600 a visit, they might think you're great and would not question > what you are doing... but since you charge little, they don't think > you know what you're doing. Crazy, eh?? Oh, and the herbs, I'm sure > you're going to find that they have estrogenic effects, but I would be > very surprised if there was any evidence that it had any effect on the > IVF... but still, it might just be wise to CYA or just stick with > acupuncture pre transfer since most are convinced it can't do anything > bad (then it couldn't do anything good either, vis a vis yin / yang, > right?). > > I had a similar situation with a young MD who sought me out when she > had a IVF cycle scheduled. She came in and her hair was thin, dry, > falling out, and she had 2 days of scanty menses. I suggested she > postpone the IVF until things were regulated, but she was anxious, did > the IVF, and didn't have good results. It may have not worked even > with regular cycles, but from our standpoint, it was not wise to try > yet. It's real frustrating when you hear all the stories about the > people who try for years and then decide to adopt, and then promptly > become pregnant. If any of the more senior practitioners here have > any advice, I'd love it if you wouldn't mind sharing! > > Geoff > > > You know, the most difficult condition to treat is anxiety. Not > because the > > problem is symptom is difficult to resolve, but because the patients are > > flighty and noncompliant. They're good for about a week, but then > they get > > (you guessed it) anxious about the formula and stop taking it. So > good luck > > on this one. > > > > -- > > , DAOM > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 22, 2007 Report Share Posted October 22, 2007 Thanks so much for your response Pamela, to answer your question: >Was she taking supplementary >progesterone after the IVF? Her progesterone issue would be the >source of my treatment plan from here out. I don't know, but I'll find out, though upon examining this case more closely, I'm very surprised that she didn't mention her progesterone levels. I purchased Lyttleton's book a few months ago, and just recently began reading it (yes, it is an amazing resource!). I'll continue to treat my patients pattern of Ki Yin Xu and Sp Qi Xu with the addition of herbs and pts to calm spirit. I imagine that including Ki Yang herbs like Ba Ji Tian, Tu Si Zi, and Lu Jiao Jiao will support her progesterone levels without depleting her yin too much. However, if you have more specific advice concerning " her progesterone issue " I would love to hear it! And if you do come across the Chen/estrogen series I would love to see that as well. Thanks again Pamela Sean , Pamela Zilavy <chexin wrote: > > This woman did not have enough progesterone to sustain the pregnancy, this is why the 'successful' IVF resulted in a miscarriage. Was she taking supplementary progesterone after the IVF? Her progesterone issue would be the source of my treatment plan from here out. Regarding your question about estrogenic herbs, this is an excellent question and anyone treating fertility should be aware of it. All OB/Gyns will ask this question if they know a pt is taking herbs. I would have to disagree with the post about " have her check with her IVF doctor to > see if this may be a common side-effect of the Follicle Stimulating > medications or progesterone injections. " As soon as the doc knows the pt is taking herbs, they will 99% surely 'blame' the herbs. This is not a 'common' side effect of hormone stim. I'm not sure why the concern about bleeding. The ART took over her hormones, then she had a miscarriage, now her body is resetting itself to start having menses. It may be a short cycle but that is the consequence of what her body has been through. > John Chen did a three part series about estrogenic herbs. I will try to find that for you Sean. In the meantime, I'd recommend getting the Jane Lyttleton book on Treating Infertility with TCM. It's worth it's weight in gold. -p > Pamela Zilavy, L.Ac. > chexin > http://www.change-exchange-interchange.com > 415) 279-8376 > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 22, 2007 Report Share Posted October 22, 2007 Sean, See my response to Pamela below before spending too much time trying to unravel the mystery of this patient's progesterone levels. David K. , " sean_michael_hall " <seanmichaelhall wrote: > > Thanks so much for your response Pamela, to answer your question: > > >Was she taking supplementary > >progesterone after the IVF? Her progesterone issue would be the > >source of my treatment plan from here out. > > I don't know, but I'll find out, though upon examining this case more > closely, I'm very surprised that she didn't mention her progesterone > levels. I purchased Lyttleton's book a few months ago, and just > recently began reading it (yes, it is an amazing resource!). I'll > continue to treat my patients pattern of Ki Yin Xu and Sp Qi Xu with > the addition of herbs and pts to calm spirit. I imagine that > including Ki Yang herbs like Ba Ji Tian, Tu Si Zi, and Lu Jiao Jiao > will support her progesterone levels without depleting her yin too > much. However, if you have more specific advice concerning " her > progesterone issue " I would love to hear it! And if you do come > across the Chen/estrogen series I would love to see that as well. > Thanks again Pamela > > Sean > > > , Pamela Zilavy <chexin@> > wrote: > > > > This woman did not have enough progesterone to sustain the > pregnancy, this is why the 'successful' IVF resulted in a miscarriage. > Was she taking supplementary progesterone after the IVF? Her > progesterone issue would be the source of my treatment plan from here > out. Regarding your question about estrogenic herbs, this is an > excellent question and anyone treating fertility should be aware of > it. All OB/Gyns will ask this question if they know a pt is taking > herbs. I would have to disagree with the post about " have her check > with her IVF doctor to > > see if this may be a common side-effect of the Follicle Stimulating > > medications or progesterone injections. " As soon as the doc knows > the pt is taking herbs, they will 99% surely 'blame' the herbs. This > is not a 'common' side effect of hormone stim. I'm not sure why the > concern about bleeding. The ART took over her hormones, then she had a > miscarriage, now her body is resetting itself to start having menses. > It may be a short cycle but that is the consequence of what her body > has been through. > > John Chen did a three part series about estrogenic herbs. I will try > to find that for you Sean. In the meantime, I'd recommend getting the > Jane Lyttleton book on Treating Infertility with TCM. It's worth it's > weight in gold. -p > > Pamela Zilavy, L.Ac. > > chexin@ > > http://www.change-exchange-interchange.com > > 415) 279-8376 > > > > Quote Link to comment Share on other sites More sharing options...
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